NPIMap

Organization Active NPI

Cedric Wilson, LPC, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roanoke, VA
National Provider Identifier
1013502137
Registry record updated Mar 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
CEDRIC WILSON, LPC, LLC
Practice address
3048 Brambleton Ave SW
Roanoke, VA 24015-4404
Phone
(540) 339-7674
Fax
(540) 685-0994
NPI assigned
Mar 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cedric Wilson, LPCNPI 1922624154
Title
Ceo & Therapist
Phone
(540) 339-7674

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

3048 Brambleton Ave SW
Roanoke, VA 24015-4404

Mailing address

2907 Oak Crest Ave SW
Roanoke, VA 24015-4609
Phone (443) 604-5945

Other names 1

  • Seeking Wellness Counseling Services Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260127002135 VA Part B Supplier - Clinic/Group Practice 1456838929 Receives reassigned benefits from 4 practitioners
Practice locations: Roanoke, VA

National Provider Directory

National Provider Directory

Locations

3048 Brambleton Ave SW
Roanoke, VA 24015
Phone (540) 339-7674

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614643200000",
    "number": "1013502137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 OAK CREST AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240154609",
            "telephone_number": "443-604-5945",
            "fax_number": "540-339-7674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 BRAMBLETON AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240154404",
            "telephone_number": "540-339-7674",
            "fax_number": "540-685-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDRIC WILSON, LPC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-02",
        "last_updated": "2021-03-02",
        "certification_date": "2021-03-02",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "CEDRIC",
        "authorized_official_title_or_position": "CEO & THERAPIST",
        "authorized_official_telephone_number": "540-339-7674",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seeking Wellness Counseling Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.